Download Forms

Come to your first appointment ready to get started. Download, print and complete these forms now. You may also want to save copies for your records.

List of Forms

Client Registration

Download this pdf and fill out the appropriate fields. Complete the Client Registration form before your first appointment at Lyn-Lake Psychotherapy & Wellness.

Client Fee Information

The Client Fee Information form outlines Lyn-Lake Psychotherapy & Wellness’ policies regarding payment. Download this form and sign it to bring with you to your first appointment.

WHO Disability Assessment

Download, print, and complete this document to self-administer the World Health Organization’s Disability Assessment

Release of information

Download, print, and complete this document to authorize individuals whom LLPW may release information about your treatment to.

Consent to treat minors

Download, print, and complete this document to authorize the treatment of minors.

HIPAA privacy practices

Download, print, and sign this document to indicate that the HIPAA privacy practices have been disclosed to you.

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Make sure to fill out all the forms you’ll need to bring them along when you visit.
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